C.W. McKeen / The Post-Standard, 2002Raul Pinet Jr. looks over his living quarters at the Onondaga County Justice Center jail's "clean and sober unit" in 2002.

By John O'Brien
and Mike McAndrew
Staff writers

Syracuse, NY -- A man in police custody died from a drug-related brain disorder and the way deputies restrained him at the Onondaga County Justice Center jail two weeks ago, the county medical examiner ruled Tuesday.

Both Raul Pinet Jr.’s cocaine-induced agitation and the way his restraints compromised his breathing contributed to his Aug. 6 death, according to Dr. Robert Stoppacher.

An autopsy and toxicology tests on Pinet’s body showed he died as a result of “cocaine-induced excited delirium,” Stoppacher said in a news release. He describes the condition as resulting from cocaine use, where the person becomes disoriented and agitated, and behaves violently.

The restraints used by deputies, where they held him facedown at the jail, contributed to Pinet’s death, Stoppacher wrote.

Pinet (pronounced pin-NET), 31, was arrested by Syracuse police on a charge of trying to break into a home on Shonnard Street. He became combative with the officers, police said. When they took him to the Onondaga County Justice Center jail, he again fought with deputies, police said.

After they subdued Pinet in a holding room, deputies removed a restraint belt and his clothes and left him lying facedown on the floor, Sheriff Kevin Walsh has said. After about five minutes of watching Pinet, deputies noticed he wasn’t moving, Walsh said.

The deputies went back into the room cautiously, aware he might be faking, Walsh said. For that reason, medical workers were not allowed in immediately, he said. Jail staff tried to revive Pinet, then called an ambulance, and he was pronounced dead at Upstate University Hospital, Walsh said.

The diagnosis of excited delirium has drawn mixed acceptance across the country since it was first labeled in 1985.

Dr. Werner Spitz, the former medical examiner in Detroit, said the condition does not exist. It’s used by medical examiners to imply natural causes in a death at the hands of police, said Spitz, who said he’s investigated more than 150 in-custody deaths.

“That is a term that is used for death during restraint,” Spitz said. “I have yet to see a case where one has died of what you call ‘excited delirium’ without interference by police.”

If police interfere with someone’s breathing by putting him facedown and compressing his diaphragm, he’s bound to get excited, Spitz said.

“The individual gets air hunger, gets fear of doom when he cannot breathe,” Spitz said. “They go crazy. They go wild. And that’s the irony of it. The police interpret that as the individual is resisting arrest, when in fact he’s fighting for his life.”

Excited delirium is a brain disorder that’s usually related to drugs, according to the University of Miami’s neurology department. Chemical systems in the brain break down, the department’s website said.

Tashara Pinet, Raul’s wife of five years, said there was a good chance her husband would be alive if police and jail deputies had followed procedures.

“No matter if someone had drugs in their system or not, there’s a certain procedure that should be followed by the people who are supposed to protect us and help us,” she said. “It’s very evident in my husband’s case that was not done.”

At the request of county officials, Stoppacher would not comment beyond his news release.

It’s not clear whether Pinet would have died if he had not been restrained, Walsh said.

“I’m not sure that one would’ve happened without the other,” said Walsh, who spoke with Stoppacher. “Since they’re both factors there, I don’t think you can eliminate either one.”

Walsh said he knew of no other excited delirium death in Onondaga County.

The medical examiner has agreed to train deputies to recognize symptoms of the condition, Walsh said.

“Had we had someone with the expertise to recognize the signs of excited delirium, we probably would not have accepted this inmate,” Walsh said. Pinet would probably have been taken to a hospital, he said.

Janet Izzo, a lawyer representing Pinet’s widow, said the medical examiner’s office has not shared its autopsy report with Pinet’s wife or with her. Based on Pinet’s history of drug use, it’s not surprising the autopsy would find cocaine in Pinet’s body, she said.

When Pinet was arrested, “he was in fear for his life. And not acting normally,” Izzo said.

District Attorney William Fitzpatrick said the medical examiner’s ruling does not end his staff’s investigation. He would not be more specific.

Fitzpatrick said he could not conclude whether Pinet’s death would have occurred without the type of physical restraint used on him by jail deputies, or whether it would have occurred absent cocaine use.